................. 11 Chapter 3. Integrate Treatment for Substance Use Disorders into Health Care and Expand Support for Recovery............................... 15 Chapter 4: Break the Cycle of Drug Use, Crime, Delinquency, and Incarceration............ 19 Chapter 5. Disrupt Domestic Drug Trafficking and Production.................. 25 Chapter 6: Strengthen International Partnerships....................... 31 Chapter 7. Improve Information Systems for Analysis, Assessment, and Local Management....... 39 Policy Focus: Reducing Drugged Driving........................... 43 Policy Focus: Preventing Prescription Drug Abuse....................... 47 Conclusion...................................... 51 List of Acronyms.................................... 53 References...................................... 57 i ★ ★ To the Congress of the United States I am pleased to transmit the 2012 National Drug Control Strategy, which follows through on the commitment made by my Administration to chart a new course in our efforts to reduce illicit drug use and its consequences in the United States. The balanced approach outlined in the Administration’s inaugural National Drug Control Strategy has yielded significant results, which are detailed in the following pages.

Our Nation still faces serious drug-related challenges, however. Too many Americans need treatment for substance use disorders but do not receive it. Prescription drug abuse continues to claim American lives, and those who take drugs and drive threaten safety on our Nation’s roadways. Young people’s perceptions of the risks of drug use have declined over the past decade, and research suggests that this often predicts future increases in drug use. There is still much left to do to reform our justice system and break the cycle of drug use and crime. Our commitment to work with partner nations must remain steadfast to reduce drug production, trafficking, and related transnational threats.

Based upon the progress we have achieved over the past three years, I am confident we can address these challenges through concerted action along the entire spectrum of prevention, early intervention, treatment, recovery support, criminal justice reform, law enforcement, and international cooperation.

However, we must match our commitment with the appropriate resources.

Illicit drug use in America contributed to an estimated $193 billion in crime, health, and lost productivity costs in 2007, the year for which the most recent estimate is available. In today’s challenging economic environment, we cannot afford such a drain on our economy and public resources. While difficult budget decisions must be made at all levels of government, we must ensure continued support for policies and programs that reduce drug use and its enormous costs to American society. In doing so, we will not only strengthen our economy but also sustain the national character and spirit that has made the United States a world leader.

I look forward to continuing to work with the Congress and Federal, state, local, tribal, and territorial leaders, international partners, and the American people in this important endeavor.

Barack ObamaThe White House

iii ★ ★ Preface from Director Kerlikowske The Administration’s inaugural National Drug Control Strategy, published in 2010, represented a new direction in our efforts to reduce illicit drug use and its consequences in the United States. The spirit and substance of that Strategy reflected the unique nature in which it was developed—at the President’s direction, the Office of National Drug Control Policy (ONDCP) engaged in an unprecedented consultation process, collecting input from Congress, Federal, state, local, tribal, territorial, and international partners, nongovernmental organizations, and the American public. Upon release of the Strategy, I committed this office to oversee its implementation with the same rigor and transparency that marked its development. This document, the 2012 National Drug Control Strategy, incorporates input from a diverse range of stakeholders while also reflecting implementation progress as reported by dozens of Federal agencies regarding the action items for which they are responsible.

This Strategy reflects new developments in our efforts to reduce drug use and its consequences, but our goal remains the same: a 15 percent reduction in the rate of drug use and similar reductions in drug use consequences over the course of five years (2010-2015). To achieve this goal, we will continue to pursue a balanced approach that brings all sectors of society together in a national effort to improve public health and safety. Through community-based programs and early intervention in health care settings, we will work to prevent illicit drug use and addiction before their onset and bring more Americans in need of treatment into contact with the appropriate level of care. We will continue to build on the Administration’s progress in reforming the justice system, ensuring that laws are applied fairly and effectively—protecting public safety while also ensuring that drug-involved offenders have the opportunity to end their drug use and rebuild their lives. We will continue to counter drug production and trafficking within the United States and will implement new strategies to secure our borders against illicit drug flows. And we will work with international partners to reduce drug production and trafficking and strengthen rule of law, democratic institutions, citizen security, and respect for human rights around the world.

Achieving the progress detailed in the following pages would not have been possible without the support of Congress, and such support will remain essential as we seek to reduce drug use and its consequences in America throughout 2012. I thank the Congress—and individuals all across the country—for their continued partnership in building a healthier and safer America.

R. Gil KerlikowskeDirector of National Drug Control Policy

v ★ ★

Introduction

In his message to Congress in the Administration’s first National Drug Control Strategy, the President affirmed that “…a well-crafted strategy is only as successful as its implementation. To succeed, we will need to rely on the hard work, dedication, and perseverance of every concerned American.” For 3 years this principle has guided the Administration’s efforts to include all sectors of American society in a comprehensive national effort to reduce illicit drug use and its consequences. The Administration’s first Strategy included 106 action items to be undertaken by Federal agencies in partnership with state, local, tribal, and international counterparts to prevent illicit drug use in our communities; intervene early in the health care system; strengthen drug treatment services and support the millions of Americans in recovery; break the cycle of drug use, crime, and incarceration; disrupt domestic drug production and trafficking; strengthen international partnerships; and improve drug-related information systems.

The 2011 National Drug Control Strategy built upon this policy framework, addressed several important legislative developments, and added a focus on the needs of special populations such as college and university students, women and families, and military members, veterans, and their families.

Progress has been achieved in a number of important areas during the past year. In 2011, the Administration announced the release of the National Prevention Strategy, which includes substance use prevention as part of a comprehensive plan to help increase the number of Americans who are healthy at every stage of life. Screening, Brief Intervention, and Referral to Treatment services continued to reach more Americans in the health care system, and more patients in health centers across the Nation were provided access to substance use disorder treatment services. Drug courts and other innovative criminal justice programs offered more drug-involved offenders the opportunity to undergo treatment as an alternative to incarceration. The Administration developed strategies to reduce the flow of drugs across both the northern and southern borders, while also addressing the threat of drug production and trafficking within the United States. Internationally, the United States strengthened bonds with partner nations, working to reduce the flow of illicit drugs to the United States while also developing a new Strategy to Combat Transnational Organized Crime that addresses the role of the drug trade in broader threats to national security. Concurrently, the Administration has worked to enhance data collection, fill information gaps, and improve the relevance of data systems in the national effort to reduce drug use and its consequences.

The Administration also maintained its focus on the key issues of drugged driving and prescription drug abuse. The President drew much-needed attention to the issue of drugged driving by declaring December National Impaired Driving Prevention Month in both 2010 and 2011. Throughout the year, the Administration advanced initiatives to improve public awareness, enhance law enforcement training, improve screening methodologies, and collect more comprehensive data to support policy-making.

In response to a prescription drug abuse problem designated as an epidemic by the Centers for Disease Control and Prevention (CDC), in 2011, the Administration moved forward with the implementation of the Prescription Drug Abuse Prevention Plan. The Plan includes four pillars to reduce prescription drug abuse: education, monitoring, proper medication disposal, and enforcement. The passage by Congress of the Secure and Responsible Drug Disposal Act of 2010 will greatly assist in the implementation of the ★ ★

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Prescription Drug Abuse Prevention Plan, allowing the Drug Enforcement Administration (DEA) to implement regulations on the disposal of controlled substances by ultimate users, long term care facilities, and other authorized persons. While the rulemaking process proceeds, DEA is working with its Federal, state, local, and tribal partners to support communities in their efforts to safely dispose unused prescription drugs through its National Prescription Drug Take Back Initiative.

Important steps have been taken to address the unique needs of special populations affected by the drug problem. With regard to college and university students, the Administration has partnered with college and university leaders to advance prevention, early intervention, treatment, and recovery initiatives on campuses across the country. The Administration initiated the VetCorps program to recruit veterans to serve in community coalitions across the country, providing economic opportunities, housing, health care, and drug prevention and treatment services for veterans and their families. And the Administration continued to provide funding support for family-based treatment and forged new partnerships to improve policies and programs responsive to the unique needs of women and families affected by drug use.

The following chapters provide progress updates on implementation of the 2010 and 2011 National Drug Control Strategy. In each chapter, action items appear in italics, with the original action item numbers from the 2010 Strategy following in parentheses. As detailed in the pages that follow, significant progress has been achieved in many important areas of the National Drug Control Strategy, but America still faces a serious drug problem that requires sustained focus and concerted action from all sectors of American society. For example, findings from the 2011 Monitoring the Future study indicate that while illicit drug use among teens did not change significantly between 2010 and 2011, there have been significant increases in past-month use since 2006, mostly driven by increased rates of marijuana use. Between 2006 and 2011, past-month use of any illicit drug among 10th graders increased from

16.8 percent to 19.2 percent. During the same time period, past-month use of marijuana among 10th graders increased from 14.2 percent to 17.6 percent.1 In pursuing the National Drug Control Strategy in 2012, we will remain flexible and adaptable, responding to new threats as they emerge. For example, the Monitoring the Future study also revealed the shocking finding that in 2011 one in nine high school seniors had used “synthetic marijuana” (synthetic cannabinoids commonly marketed as “herbal incense” in products such as “Spice” or “K2”) during the past year, meaning that synthetic cannabinoids are now the second most frequently used illicit drug, after marijuana, among high school seniors.2 These substances can cause serious adverse health effects;

calls to Poison Control Centers relating to synthetic cannabinoids reached 6,890 in 2011—more than double the number received in all of 2010.3 The Administration has responded rapidly to the emerging threat of synthetic drugs, convening Federal agencies and nongovernmental organizations to develop a coordinated response. DEA has taken emergency action to temporarily control five synthetic cannabinoids and three synthetic cathinones that are common ingredients in these dangerous substances.

In December 2011, the House of Representatives passed legislation that would ban several synthetic drugs, including some that are marketed as “bath salts.” After passage in the House, the bill was referred to the Senate. The Administration will continue to work with Congress to address the synthetic drug threat throughout 2012. ★ ★

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